Principle in administration of medication via injection

1. PRINCIPLE IN ADMINISTRATION OF
MEDICATION VIA INJECTION
SN MUHAMMAD HAMZIHADI
BIN HAMRAH
ICU 5C
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2. CONTENTS
• Objectives
• Anatomy of skin
• Anatomy of syringe
• Types of injections
▫ Intradermal
▫ Subcutaneous
▫ Intramuscular
• Take home message
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3. OBJECTIVES
• Able to understand the anatomy of syringe and
skin in the end of this seminar
• Able to understand principle of intradermal
injection
• Able to understand principle of subcutaneous
injection
• Able to understand principle of intramuscular
injection
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4. Anatomy of Skin
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5. Anatomy of Syringe
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6. GAUGE OF THE NEEDLE SYRINGE
THE LARGER THE GAUZE , THE
SMALLER THE SIZE
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7. Introduction
• Worldwide, injections are one of the most
common medical procedures, with an estimated
12 THOUSAND MILLION INJECTIONS
administered each year. A large majority, more
than 90%, of these injections are administered
for curative purposes (WHO, 2016).
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8. Introduction
• However, it requires knowledge of
ANATOMY AND PHYSIOLOGY,
pharmacology, psychology,
communication skills and practical
expertise.
• A safe injection is one that does not
harm the recipient.
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9. Introduction
• It is an infusion method of putting fluid
into the body, usually with a syringe and a
hollow needle which is pierced through
the skin to a sufficient depth for the
material to be administered into the body.
• Syringe – a device made of a hollow tube
and a needle that is used to force fluids
into or take fluids out of the body
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10. 7/25/2021
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11. Type of injections
INTRADERMAL
INJECTION
SUBCUTANEOUS
INJECTION
INTRAMUSCULAR
INJECTION
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12. INTRADERMAL
INJECTION
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13. INTRADERMAL INJECTION
• It is the introduction via needle of tiny
amounts of fluid into layers of skin.
• It provides a local, rather than systemic effect.
• Syringe used is 1ml tuberculin syringe because
of a very small amount of drug needed.
• Needle used is a short (1/4 to 5/8 inch), fine
gauge (g25-27).
• Indications:
For diagnostic purposes (allergies and
sensitivities to drugs)
• For administering tuberculin testing
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14. INTRADERMAL INJECTION
• Intradermal literally means
“between the skin layers”
and injection is
administered just under the
epidermis .
• Syringe is positioned at 15˚
angle.
• Small volumes, usually 0.01
to 0.05ml, are injected
because of the small tissue
space.
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15. INTRADERMAL INJECTION
• Most commonly used site: Inner surface of
the forearm
• Subscapular region of the back can be used as
well as the deltoid region.
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16. REMEMBER:
• Inject the solution
intradermally and just enough
to form a wheal.
• Encircle the site correctly and
write the time when to check
the injection site to determine
reaction to the drug.
• Check the site after 30
minutes for signs of reaction.
INTRADERMAL INJECTION
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17. INTRADERMAL INJECTION
REMEMBER:
• A positive result may be manifested by any of the
following:
1. Reddening of the site accompanied with marked
elevation
2. Increase in circumference of the wheal
3. Presence of itchiness on the site
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18. INTRADERMAL INJECTION
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19. SUBCUTANEOUS
INJECTION
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20. SUBCUTANEOUS INJECTION
• Subcutaneous tissue lies
between the epidermis and
the muscle.
• Subcutaneous route is used
for slow, sustained
absorption of medication.
• SC or SQ
Indications:
• Used commonly for insulin
injections
• Heparin
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21. SUBCUTANEOUS INJECTION
Common sites used for SQ
route:
• Outer aspect of the upper arm
• Abdomen(from below the
costal margin to the iliac
crests)
• Anterior aspects of the thigh
• Upper back
• Upper ventral or dorsogluteal
area
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22. SUBCUTANEOUS INJECTION
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23. SUBCUTANEOUS INJECTION
REMEMBER:
• Hold syringe in the dominant
hand between the thumb and
forefinger.
• Inject the needle quickly at an
angle of 45 to 90 degree,
depending on the amount and
turgor of the tissue and the length
of the needle.
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24. SUBCUTANEOUS INJECTION
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25. Do and don’t
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26. 7/25/2021
Do and don’t
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27. SUBCUTANEOUS INJECTION
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28. INTRAMUSCULAR
INJECTION
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29. INTRAMUSCULAR INJECTION
• The intramuscular (IM) route injection delivers
medication into well perfused muscle, providing
rapid systemic action and absorbing relatively
large doses.
• Gastric disturbances do not affect the
medication.
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30. INTRAMUSCULAR INJECTION
• Absorption occurs even
more rapidly than with SQ
route because of greater
vascularity of muscle
tissue.
• Irritating drugs are
commonly given IM
because very few nerve
endings are in deep
muscle tissues.
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31. SITES OF INTRAMUSCULAR INJECTION
• Deltoid muscle of the
upper arm –
Preferred site for
vaccinations in adults.
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32. SITES OF INTRAMUSCULAR INJECTION
• Dorsogluteal –
Performed by entering
through the gluteus
maximus muscle. Care
should be given to avoid
damage to the sciatic nerve
and vessels surrounding
this area.
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33. SITES OF INTRAMUSCULAR INJECTION
• Ventrogluteal – Safer
option which accesses the
gluteus medius muscle.
(Primary location for IM
use as it avoids all major
nerves and blood vessels)
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34. SITES OF INTRAMUSCULAR INJECTION
• Vastus Lateralis – A
quadriceps muscle situated
on the outer side of the
femur and is used as a
primary site for children. It
does have risks associated
to it due to overuse but has
been suggested safe for
children up to seven months
old.
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35. SITES OF INTRAMUSCULAR INJECTION
• Rectus Femoris –
Anterior quadriceps
muscle which is rarely
used by
physicians/nurses but
is easily accessed for
self- administration,
or for infants.
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36. PROCEDURE INTRAMUSCULAR
INJECTION
1. Prepare needed materials aseptically.
2. Check the label of the drug three times.
3. Prepare the medication.
4. Position the patient and locate the site
correctly.
5. Cleanse the site using circular motion
from inner to outer portion and allow it to
dry.
6. Place a swab between fingers of non-
dominant hand.
7. Spread tissue and insert needle quickly at
90 degrees angle in a dartlike position.
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37. PROCEDURE INTRAMUSCULAR
INJECTION
8. Pull back the plunger to check for blood.
9. Inject the medication slowly if no blood
appears. Withdraw needle quickly.
10.Apply pressure and dry cotton ball to the site
and massage.
11. Leave the client in a comfortable position.
12. Dispose the syringe and other materials used
properly, wash hands and document the
procedure.
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38. PROCEDURE INTRAMUSCULAR
INJECTION
• REMEMBER:
• Apply pressure to site and
massage after (To prevent
hematoma on the injection
site and prevent oozing of
blood and for proper
absorption of the
medicine)
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39. ?????
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40. INTRAMUSCULAR INJECTION
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41. Take Home Message
• Understand the anatomy of skin and syringe are
fundamental for every nurses before practicing
injection
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42. Q and A
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